Diabetes Health

Asian-Caucasian Couples at Higher Risk for Gestational Diabetes

Couples made up of one Asian and one Caucasian partner may face an increased risk of gestational diabetes and a higher risk of Caesarean delivery, say researchers in the American Journal of Obstetrics and Gynecology.

Researchers at Stanford University School of Medicine looked at data from Caucasian, Asian, and Asian-Caucasian couples who delivered at Stanford from 2000 to 2005.

During that time, 5,575 Caucasian, 3,226 Asian, and 868 Asian-Caucasian couples delivered babies at the hospital.

Lowest Rates in All-Caucasian Couples

The researchers found that Caucasian mothers whose partners were Asian fathers had the lowest rate of Caesarean delivery at 23 percent.

Asian mother/Caucasian father couples, though, had the highest rate, with 33 percent of pregnancies resulting in Caesarean deliveries.

The researchers conclude that since the birth weights between the two groups are similar, the increased rate of Caesarean deliveries among Asian mother/Caucasian couples may be due to the smaller pelvis size of the average Asian woman, as compared to the average Caucasian woman. Asian women, therefore, may be limited in the size of baby they can accommodate.

Therefore, Asian women may be less likely to be able to accommodate babies of a certain size.

The researchers also found that the rate of gestational diabetes was lowest among Caucasian couples (1.6 percent) and highest among Asian couples (5.7 percent).

For Asian-Caucasian couples, the rate of gestational diabetes was just under 4 percent.

Previous studies have found an increased genetic risk for diabetes among Asian couples. Of interest is that the results of this study indicated an equal risk for gestational diabetes regardless of which partner was Asian.

The results of this study are particularly interesting, since the risk of gestational diabetes was about the same regardless of which person was Asian.

Findings Help Physicians Advise Patients

Researchers say these findings are important for health care professionals who are counseling women about their pregnancy risks.

"One has to factor in as many relevant variables as possible when you counsel a patient about pregnancy," says study co-author Dr. Yasser El-Sayed, an associate professor of obstetrics and gynecology at Stanford.

"We've shown in this paper that if you have an interracial couple, depending on which parent is of which race, there may be different relative risks of certain outcomes that could inform and enhance clinical management," he says.

Always consult your physician for more information.

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Gestational Diabetes Defined

Gestational diabetes is a condition in which the glucose level is elevated and other diabetic symptoms appear during pregnancy in a woman who has not previously been diagnosed with diabetes.

All diabetic symptoms disappear following delivery.

Unlike type 1 diabetes, gestational diabetes is not caused by a lack of insulin, but by blocking effects of other hormones on the insulin that is produced, a condition referred to as insulin resistance.

Approximately 7 percent of all pregnant women in the US are diagnosed with gestational diabetes.

Although the cause of gestational diabetes is not known, there are some theories as to why the condition occurs.

The placenta supplies a growing fetus with nutrients and water, as well as produces a variety of hormones to maintain the pregnancy.

Some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.

As the placenta grows, more of these hormones are produced, and insulin resistance becomes greater.

Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.

Although any woman can develop gestational diabetes during pregnancy, some of the factors that may increase the risk include obesity, family history of diabetes, having given birth previously to a very large infant, a still birth, or a child with a birth defect, having too much amniotic fluid, and age (women who are older than 25 are at a greater risk for developing gestational diabetes than younger women).